A few years ago, I was a
participant/observer of an eight-week series of educational therapy sessions
for sex offenders in a men's prison.† My
objective was to understand how the sex offender treatment program aimed to
teach victim empathy to the inmates so as to be in a position to offer a
philosophical analysis of this aspect of treatment.[1] I
learned a number of things that summer, the most important of which was that
sexual offending is complex and difficult to generalize about. Thus, it was
with great interest and some skepticism that I sat down to read the essays in
the book Sexual Deviance.

This anthology is a very fine
collection of critical essays on causal theories, treatments, and interventions
for sexual offenders. It serves as an invaluable tool for clinicians, criminal
justice professionals, and policy-makers. I would use a number of chapters to
teach Ph.D. students in social work. Many authors also give suggestions for
much-needed research projects, so graduate students will gain many ideas of
issues to study in this field.

The book is divided into two
roughly even parts, the first on explanatory models and the second on responses
to sexual deviance. Some chapters give critical overviews of prevailing
theories and suggest alternatives. For example, Tony Ward and Laura Sorbello in
the opening chapter criticize three causal theories of child sexual abuse and
offer a pathways model in which they identify multiple pathways that can lead
to offending behavior. In "Back to the Future?" Richard Siegert and
Tony Ward survey evolutionary explanations of rape. Authors provide a critical
commentary after presenting each theory. I steeled myself to read the chapter
on evolutionary theories of rape but found the authors to be even-handed and
judicious in their weighing of strengths and weaknesses. This format, although
not used or needed in most chapters, is very useful for clinicians and
students. Other chapters primarily focus on new developments or directions. The
chapter by Tony Ward and Claire A. Stewart, "Good Lives and the
Rehabilitation of Sexual Offenders," is a very fine piece of theorizing
that draws on philosophical ideas of human flourishing. Ward and Stewart are
critical of models of rehabilitation that focus on risk reduction because such
models fail to attend to the basic needs (goods) that we all require to live an
adequately satisfying life. These authors suggest that treatment be built
around the questions "What kind of person would you like to be?" and
"What kind of life would this require?"† Thus, treatment should be organized around helping patients who
sexually offend to live better, if not good, lives.

There is likely to be a great
variety of approaches to those questions, depending on the strengths, skills,
vulnerabilities, and needs of individual patients, and Ward and Stewart
recognize this possibility. They suggest that therapists tailor a conception of
the good life to the individual who has sexually offended and to customize the
treatment plan accordingly. In fact, this attention to differences is a strong
feature of the anthology. At numerous points in these chapters, authors take pains
to point out the messiness of theory and the dangers in oversimplification, so
that readers are guided away from drawing erroneous generalizations.
Christopher Drake and Tony Ward, in a chapter arguing for a formulation-based
approach to treatment rather than a manual-based one, base their suggested
approach on the point that "the most serious shortcoming of all in the
current etiological theories is the tendency to describe the offense and
relapse processes as if they occurred in the same way for every offender."
One clear theme of the book is that sexual offences have a variety of causes
and that people who sexually offend vary in personality, narrative history,
cognitive ability, social scripts, kind of desire, attitudes toward their
offending behavior, and so on. Because so much variation exists, we need
treatment programs that are responsive to individual differences. Readers,
then, will come away from this book with an appreciation and understanding of
the many differences among sex offenders. In addition, differences between
clinician and patient must also be considered. Marie Connolly, in
"Cultural Components of Practice," reminds clinicians of the need to
monitor themselves so that they do not impose their own cultural values and
assumptions on their clients. This point may seem obvious, but Connolly does a
very good job of motivating this claim by analyzing interactions in an actual
case.

Connolly is one of the few
authors who includes an example or case study, and the meager offering of
examples is unfortunate. Theory comes to life with examples for readers to work
with. And, while probably only a reviewer would sit down and read this book
cover to cover, I do think it is a bit dry even in shorter spurts. The editors
could have omitted some of the chapters and expanded others with examples.
Those who use this book for teaching purposes will need to find a way to
incorporate the problems and needs of actual living people who sexually offend
in order to flesh out (so to speak) the theory and science in the book.

Another area where this anthology
could have been stronger is that of philosophical connections. I realize that
the subject matter is science, not philosophy, but many of the authors touch on
important philosophical issues such as what it means to live a good life, what
empathy is, or what constitutes ethical treatment of sex offenders. Those
subjects are clearly philosophical, and readers would benefit if the authors
had incorporated readings from the discipline of philosophy. (Ward and Stewart
draw on Martha Nussbaum's work, but this is the exception.) For example, having
done research myself on the victim empathy focus of a sex offender treatment
program, it was with great eagerness that I read the chapter on victim empathy
by Devon L. L. Polaschek. But Polaschek's discussion of empathy as a concept is
thin and misleading for readers. She says that empathy is difficult to define
and raises questions to which philosophers have already worked out
sophisticated and rich answers.[2] The
chapter "Developmental Antecedents of Sexual Offending" has a
discussion of theory of mind that fails to draw upon the rich body of knowledge
in philosophy of mind. I can see many areas where some philosophical material
(or collaboration with philosophers) would bolster arguments and clarify
concepts.

Nevertheless, it is unusual to
find an anthology where the authors consistently define their terms. This style of
writing makes the material accessible to the non-clinician and non-researcher
and provides clarity in a subject where there is room for much
misunderstanding. In addition to defining terms, many authors offer a
conceptual analysis of terms. Ruth E. Mann and Anthony R. Beech, for example,
point out that the idea of cognitive distortion which underpins both explanatory
theory for some offending and cognitive behavioral treatment approaches assumes
that we know what cognitive distortion is and even what a cognitive schema is.
They offer analyses of both concepts, although the emphasis is on the former.

Still, I would have liked a
rigorous definition and defense of the umbrella term sexual deviance--and
deviance in general, for that matter.[3] Given
the title, readers might expect the book to include normatively deviant
behavior for which the status could be challenged. And in fact, Richard Laws
does briefly raise the question about what counts as deviant or normal in
"Harm Reduction and Sexual Offending." But where is the analysis of
those who enjoy spankings? Or have shoe fetishes? How does deviant behavior differ
from transgressive behavior?

It turns out that "sexual
deviance," as these authors frame it, concerns criminal sexual expression
and not just socially deviant sexual expression. (One might wish the title had
clearly signaled the domain.)†

The focus on criminal sexual
deviance does not lead to reducing individuals to their offences, though. Many
of the authors emphasize the humanity of those who sexually offend. This point
is crucial to make, because many people who come into contact with sex
offenders only in legal professions tend to carry with them assumptions about
the "sickness" or "evil" of people who commit sex crimes.
(I hear this bias when I teach philosophy of law, as well.) While I worked with
inmates in the victim personalization phase of the sex offender treatment
program, one of the most significant shifts in my cognition was in the way I
perceived the men--that is, as human beings and not mere offenders. William
Glaser is emphatic on this point, criticizing current treatment programs for
being dogmatic and exercising control over the thoughts and feelings of those
who offend. Glaser's chapter gives a balanced and lucid discussion of
pharmacological treatments for sexual offenders, but he also attends to ethical
problems in treatment such as coercion. He ends with a strong indictment of
treatment programs: "Indeed, it is debatable as to whether (ethically
speaking) they now carry out 'treatment' at all. 'Social control' or even
'social defense' might be more accurate (and less hypocritical) definitions of
their aims."

The importance of
reconceptualizing the offending person and sexual deviance is taken up by Laws
in "Harm Reduction and Sexual Ofending." In this chapter, Laws
applies a model from substance abuse treatment programs that focuses on harm reduction
rather than complete abstinence. The idea is that, instead of ostracizing,
medicalizing, criminalizing, or psychologizing sexually deviant people, we
should keep them in the human community and treat them as best we can. Laws
carefully argues for this position, responding to anticipated objections in a
persuasive manner. Harm is on a continuum, and if we examine what is actually
accomplished in treatment programs, harm reduction is the result. I was
initially resistant when reading this chapter, but I found myself agreeing with
Laws on many points. It is a provocative chapter that challenges fundamental
conceptual frameworks and norms in many societies and should be read by
everyone working in the field of sex offenders.

It is curious that not once in
this anthology is the possibility raised that an offence-prone individual may
be encouraged to see others as objects through cultural imagery. It is true
that pornography is mentioned in passing. But images of eroticized violence and
sexualized children abound in mainstream media and, while such images do not
cause people to be sexually offend, they might convey the message to those
already at risk to offend that some human beings exist for their pleasure. Even
the chapter by Laws on sexual offending as a public health problem doesn't take
up the question of the role that sexual representations may play in shaping
cognitive schemas; laws discusses the importance of public education but does
not raise the issue of educating the public into a culture of respect. Perhaps
that educational objective is too ambitious for a public health campaign, and
perhaps, too, the subject of possible effects of media representations on
at-risk individuals is beyond the scope of the book. What this book does have
to offer is a broad array of theories and research ideas for working with
sexual offenders, and that is no small offering.

Nancy Nyquist Potter, Department of Philosophy, University of Louisville, Kentucky.

[1].† My philosophical analysis can be found in "Can Prisoners
Learn Victim Empathy? An Analysis of a Relapse Prevention Program in the
Kentucky State Reformatory for Men," in†
Putting Peace into Practice:
Evaluating Policy at Local and Global Levels, ed. Nancy Potter, Amsterdam:
Rodopi Press forthcoming.

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